AI scribe and clinic software for chiropractors

The chiropractic note, from red flags to plan of care

Most chiropractors write a SOAP note. The subjective section holds the complaint, onset and mechanism, the red flag screen for cauda equina, fracture, infection and cancer, and the patient's goals. The objective section holds posture, active range of motion, orthopaedic and neurological tests, and palpation findings at a named segment. The assessment is a working diagnosis, and the plan names the techniques, the home exercise and the number and spacing of visits. wai reads the same captured note in SOAP, problem-oriented or narrative view, whichever the chiropractor prefers.

The UK Code sets the content. The General Chiropractic Council's Code of Professional Practice, in effect since 1 January 2026, requires a recorded case history, planned health outcomes measured with recognised outcome measures, a recorded working diagnosis or rationale for care, and a recorded plan of care with formal reassessments at regular intervals.¹ In practice that means a baseline score on a validated tool such as the Oswestry Disability Index, the Neck Disability Index or the Bournemouth Questionnaire, and the same tool repeated at each reassessment. NICE advises considering risk stratification such as the STarT Back tool at the first contact for each new episode of low back pain, and considering manual therapy only as part of a treatment package that includes exercise.³

In the US, Medicare sets the documentation for spinal manipulation. The primary diagnosis must be subluxation at a stated level, and a subluxation shown by examination needs two of four findings, pain or tenderness, asymmetry or misalignment, range of motion abnormality and tissue or tone change, one of which must be asymmetry or range of motion.² A template with a field for each keeps a draft from missing one.

Codes come from the note. wai suggests ICD-10 and SNOMED CT codes, each shown beside the line of the consultation it rests on, for the chiropractor to confirm. Typical ones are M54.5 for low back pain, M54.4 for lumbago with sciatica, M54.2 for cervicalgia and G44.2 for tension-type headache in the WHO ICD-10 used in the UK. In the US, ICD-10-CM splits low back pain into codes such as M54.50, and Medicare claims carry segmental and somatic dysfunction codes such as M99.03 for the lumbar region and M99.01 for the cervical region. Manipulation procedure codes, CPT in the US, stay with the clinic's biller.

Adjustments are done, not said. An ambient scribe captures speech, so the segment, the side and the technique enter the note when the chiropractor says them aloud, a habit the physiotherapy guide covers in detail.

Letters to the patient, the GP and the insurer

The patient letter carries the plan of care. The Academy of Medical Royal Colleges recommends that most outpatient letters are written to the patient with a copy to the GP, and that writing to patients is the default setting for an AI scribe.⁷ For a chiropractor, that letter explains the working diagnosis in plain words, sets out the visits and exercises agreed, says when progress will be measured, and lists the symptoms that mean urgent care instead of the next appointment.

Referral letters go to the GP when the red flag screen raises a concern, when imaging or medication needs a medical opinion, or when progress stalls at reassessment. wai drafts each with the findings and the question for the GP, in the shape set out in the referral letter. Chiropractors are not among the professions that can certify a fit note, which are doctors, nurses, occupational therapists, pharmacists and physiotherapists, so work advice goes in the patient letter or to the GP.⁴

Insurers and solicitors want reports. A private medical insurer funding care often asks for the diagnosis, the treatment to date and the outcome scores before it authorises more visits, and a personal injury claim after a road traffic collision may call for a medico-legal report. wai drafts medico-legal and expert reports from the record, and an insurer progress report runs as a clinic template, each held for the chiropractor to sign and downloaded as a PDF.

Consultations in the patient's own language

wai works in 60 languages, among them English, Arabic, Spanish, French, Portuguese, Italian, Russian, Polish, Turkish, Urdu and Mandarin. A patient can mix English with Spanish, French, Portuguese, Russian, Italian, Dutch, German, Hindi or Japanese in one visit, and the other languages are captured in that language. The signed note is written in English for the record, or in another language the clinic chooses.

For a chiropractor, the part that matters most is what the patient takes home. The plan of care, the exercises and the warning symptoms can be translated into the patient's language beside the English summary, with emergency numbers kept exactly as written. The multilingual scribe page shows how it works.

Clinic software for chiropractic clinics, from plan of care to reassessment

A chiropractic clinic runs on courses of visits. Patients request appointments through booking links that read each chiropractor's calendar, reminders go out before every visit, and a cancellation is offered to the waitlist so the slot fills. Calls, email, web forms and WhatsApp land in one thread per patient, and each reply is drafted in the clinic's voice for a person to approve before it is sent.

Money is handled through the clinic's own Stripe account, with deposits for new patient assessments, payment links, memberships and insurer invoices. The GCC Code requires the clinical plan of care to be set separately from any financial payment plan, and a payment plan must not run beyond the care in the initial plan.¹ In wai the plan of care sits in the signed note and the payment sits in billing, so they stay separate documents.

Reassessment is where courses slip. wai sends recalls for the reassessment visit, each message approved by a person, and the after-visit companion tracks the GP referral and the follow-up until each is done. Before every visit the chiropractor sees a sourced brief of the patient, with the last outcome score and plan traced to the visit it came from. More on the front desk is on the clinic management software page.

One new patient visit, start to finish

Take a 46-year-old warehouse supervisor with three weeks of low back pain spreading into the left buttock after lifting a pallet. He speaks Portuguese at home and moves between Portuguese and English as he talks. The chiropractor asks about bladder and bowel function, saddle numbness, night pain, weight loss and fever, and each answer is negative. He scores 38% on the Oswestry Disability Index and sits in the medium risk group on the STarT Back tool.

The chiropractor narrates the examination. Lumbar flexion stops at the knees with pain, extension is painful at the end of range, straight leg raise is negative on both sides, reflexes and sensation are normal, and there is tenderness and restricted movement at L5 and the left sacroiliac joint. They agree six visits over four weeks of manipulation and soft tissue work with a graded home exercise programme, and a reassessment at visit six with the same questionnaire.

The draft SOAP note lists each red flag question with its answer, the examination findings by test, the working diagnosis and the plan of care with the reassessment date. wai suggested M54.4, lumbago with sciatica, and M54.5, low back pain. The chiropractor chose M54.5, because the pain stops at the buttock and the nerve tests are normal, corrected one segment the draft had heard as L4, and signed.

What went out was a letter to the patient, copied to his GP, setting out the plan in plain words, the exercises, and the symptoms that mean going to an emergency department that day, with a Portuguese translation beside the English. The front desk sent a booking link for the six visits, took the deposit through a payment link and set the reassessment recall for visit six.

The evidence behind wai's method

The note is one part of the day the evidence measures. In a randomised trial of 238 outpatient physicians across 14 specialties at UCLA Health, the ambient scribe with a significant effect cut the time spent writing each note by about 41 seconds, against 18 seconds in usual care.⁵ At The Permanente Medical Group, 3,442 physicians used an ambient scribe across 303,266 encounters in its first ten weeks.⁶ Those studies measured physicians, not chiropractors, so wai also takes on the letters, the recalls and the bookings, where a chiropractic day loses its time.

The regulator asks for a full record. The GCC Code requires records that are up to date, legible and attributable and that accurately represent each interaction with the patient, and it requires valid, recorded consent before a recording of the patient is made.¹ wai holds every draft until the chiropractor signs it, and the chiropractor asks for and records the patient's consent to capture at the start of the visit, as the consent guide explains.

The patient's own language. In a systematic review of 33 studies, 76% found at least one outcome better when patient and physician shared a language other than English.⁸

Measured in a working clinic. At The Wellness in London, which runs on wai every day, every clinician has 15 hours a week back, as published in the customer story.⁹

Where to start

Start with new patient assessments for one chiropractor. In week one, build the SOAP template with fixed fields for the red flag screen, segment and side, the outcome measure baseline and the plan of care, and measure the time from the end of each visit to a signed note. In week two, add the patient letter in the patient's language and turn on reassessment recalls, then count how many corrections each draft needs to segment levels and red flag answers.

After a month, audit twenty notes against the GCC Code's outcome measure and plan of care requirements. Compare the chiropractic workflow with the MSK guide and the osteopathy guide, see every profession on the specialties hub, and read how the scribe works on the wai Clinicians page. Prices are on the pricing page.

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